肺表面活性物质治疗新生儿重症胎粪吸入综合征疗效观察

The Clinical Effect of Pulmonary Surfactant on Neonatal Severe Meconium Aspiration Syndrome

目的:探讨肺表面活性物质(PS)治疗新生儿重症胎粪吸入综合征(MAS)的临床疗效。方法:将新生儿MAS患儿52例随机分为治疗组和对照组各26例。两组均给予上呼吸机及常规治疗,治疗组在气道充分灌洗后应用肺表面活性物质(固尔苏)100～150 mg/kg气管内给药。观察两组患儿的氧合功能、病程及预后,并进行统计学分析。结果:治疗组患儿的氧合指数低于对照组(P<0.05),动脉/肺泡氧分压比值高于对照组(P<0.05),治疗组上机时间、住院时间、并发气胸和呼吸机相关性肺炎(VAP)均少于对照组(P<0.05)。结论:肺表面活性物质能有效改善MAS患儿的肺氧合功能,缩短机械通气时间、住院时间及病程,减少气胸及VAP的发生。

Objective： To explore the clinical effect of pulmonary surfactant（PS） on severe meconium aspiration syndrome（MAS）.Method： Fifty two neonates with severe MAS were randomized into a treatment groups（26 cases） and a control group（26 cases）.Two groups received standard care,including mechanical ventilation if needed.The treatment group received Pulmonary surfactant 100-150 mg/kg additionally.Oxygenation function,clinical course and outcome of the neonates were observed,collected and statistically analyzed.Result： Oxygenation index of neonates in the treatment group was lower than that in the control group（P0.05）,and the ratio of alveolar-arterial oxygen gradient of neonates in the treatment group was higher than that in the control group（P0.05）.Neonates in the treatment group had a shorter duration of mechanical ventilation and hospitalization,and lower incidence of pneumothorax and ventilation associated pneumonia（VAP） than those in the control group（P0.05）.Conclusions： Pulmonary surfactant can significantly improve the oxygenation function,shorten the duration of mechanical ventilation and hospitalization,and decrease the incidence of pneumothorax and VAP in neonates with MAP.